What are common ankle ligament injuries?
Common ankle ligament injuries affect the strong bands of tissue that help stabilise the ankle during walking, landing, and change of direction. The most common injury is a lateral ankle sprain. This usually involves the anterior talofibular ligament, the calcaneofibular ligament, or both.
Less often, the deltoid ligament on the inside of the ankle is injured. A syndesmosis injury, often called a high ankle sprain, affects the ligaments between the tibia and fibula above the ankle joint.
- Lateral ligament injuries: usually occur when the foot rolls inwards and stresses the outer ankle.
- Deltoid ligament injuries: affect the inner ankle and can occur with a stronger twisting injury.
- Syndesmosis injuries: involve the ligaments above the ankle joint and often feel worse with twisting or pushing off.
Which ankle ligaments are most often injured?
The anterior talofibular ligament is the most commonly injured ankle ligament. It often gets injured first during a lateral ankle sprain, especially when the foot points down and rolls in. With more force, the calcaneofibular ligament may also be injured. The posterior talofibular ligament is less commonly injured.
Ankle anatomy in simple terms
The main ankle joint joins the tibia, fibula, and talus. Below it sits the subtalar joint, which helps the foot adapt to uneven ground. Ligaments connect these bones and help stop excessive movement, especially during walking, landing, cutting, and sport.
What causes common ankle ligament injuries?
Most ankle ligament injuries happen after a twist, roll, awkward landing, sudden change of direction, or contact in sport. Previous sprains, reduced ankle strength, poor balance, and returning to sport too early can all increase your risk. If the ankle stays painful or unstable, related problems such as anterior ankle impingement or a repeat sprained ankle may also need review.
How do you know whether it is a low or high ankle sprain?
A low ankle sprain usually causes pain and swelling around the outside of the ankle. A high ankle sprain often causes pain above the ankle joint, especially with twisting, walking, cutting, or pushing off. High ankle sprains can take longer to recover because the syndesmosis helps control the joint between the lower leg bones.
Low vs high ankle sprain
- Low ankle sprain: pain and swelling usually sit around the outside ankle ligaments.
- High ankle sprain: pain often sits higher above the ankle and may worsen with twisting.
- Recovery: high ankle sprains often need a slower and more careful return to running or sport.
What symptoms suggest an ankle ligament injury?
Symptoms depend on which ligament is involved and how severe the injury is. Mild sprains may mainly cause local tenderness and swelling. More severe injuries can make weight-bearing difficult and leave the ankle feeling unstable.
- pain on the outside or inside of the ankle
- swelling and bruising
- pain with walking, running, jumping, or stairs
- tenderness over the injured ligament
- a feeling that the ankle may give way
- pain higher above the ankle in syndesmosis injuries
How are common ankle ligament injuries diagnosed?
A physiotherapist will usually assess how the injury happened, where your pain sits, how much swelling you have, and whether you can walk. They may test ligament tenderness, ankle movement, loading tolerance, balance, and functional control. If your symptoms suggest a fracture, severe syndesmosis injury, or another structural problem, imaging may be recommended.
If you want broad public-health advice on early care, Healthdirect’s guide to sprained ankle management is a useful reference.
